- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,401.20 / $22,267.90 / $27,424.70
| Facility | | $18,401.20 | $22,267.90 | $27,424.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,010.71 / $19,668.41 / $20,009.13
| Facility | | $18,010.71 | $19,668.41 | $20,009.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $150.00 / $150.00
| Facility | | $150.00 | $150.00 | $150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,572.36 / $22,717.73 / $35,598.37
| Facility | | $17,572.36 | $22,717.73 | $35,598.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,540.49 / $28,707.26 / $37,885.85
| Facility | | $21,540.49 | $28,707.26 | $37,885.85 |